A More Positive Culture by Resin-containing Media Usage after Suspicious Arthroscopic Infections in Patients Receiving Antimicrobial Therapy

Background: Although infections following arthroscopic surgery of cruciate ligament and meniscus are uncommon,they have potentially serious consequences for the graft and articular cartilage. This study aimed to investigatethe efficacy of correct sampling and appropriate media, especially resin-containing media, for the detection ofinfections in patients receiving antibiotics under suspicion of joint infection after arthroscopic anterior cruciateligament (ACL) and meniscal surgery. In such cases, proper sampling and the use of suitable culture media thatcause the neutralization of antibiotics are very effective in isolating microorganisms from the patient samples andpositive cultures.Methods: In total, ۱۰ patients who had received antibiotics with suspected knee infection after arthroscopic ACLand meniscal surgery were identified after referral to surgeons during a period of ۱۰ months and investigated in thisstudy. The sample collection, culture on various media (i.e., resin-containing culture media), microbiological tests,and antibiotic susceptibility tests were performed in this study. The amplification of the mecA gene using PCR assaywas accomplished for methicillin-resistant staphylococcus strains.Results: This study was conducted on ۱۰ patients who underwent arthroscopic procedures and had receivedantibiotics. Overall, joint fluid and tissue culture were positive in ۶۰% of the patients. The resin-containing mediarevealed a trend toward increased detection of bacteria. Coagulase-negative staphylococcus strains were the mostfrequently isolated bacteria in arthroscopic ACL surgery infections. Out of five methicillin-resistant staphylococcusstrains, four strains were found that were resistant to cefoxitin and positive-mecA designated as methicillin-resistantstrains. Except for one case, the rest of the staphylococcal strains were resistant to methicillin but susceptible tovancomycin.Conclusion: Despite uncommon and low percentage of infections after arthroscopic ACL and meniscal surgery,the results of our study showed that correct sampling, appropriate cultures, especially aerobic and anaerobic resincontainingmedia, and microbiological testing remained useful and valuable for diagnosing bacterial infections.Level of evidence: II

Keywords:

Arthroscopy , Anterior Cruciate Ligament and meniscal surgery , Infection , Resin-containing culture media